♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the Internet ♪ (techno music)
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the Internet. (hands clapping)
- In our opinion of course, Bob.
- Today Brad, we're gonna talk about safe
ab and hip exercises with low back pain and sciatica,
and this is very crucial because you don't wanna stop
working out because you have back pain.
In fact, some of these could help your back pain
and strengthen your core.
- If you do 'em properly. - If you do 'em properly.
- And that's what we're gonna explain--
- Go over today. - There you go.
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- There you go.
- All right Brad, you gonna go to work?
- Oh yeah, that's right, I'll be back.
So this is a nice topic for me 'cause with spondylolisthesis
which is a chronic, often times a chronic back pain--
- So one of the vertebrae shifted forward on the other one.
- Right, and you can have sicatica associated with it,
back pain with it, which I've been dealing with
for about eight, nine years now.
- You have done a tremendous job with it, Brad.
I mean, seriously, for how active you are
and what you still do with the amount of
back injury you have,
it really (clapping) to be applauded.
- Well thank you Bob,
but it's been homework. - Yeah, it's been homework.
You worked hard on it,
and you've strengthened your core.
- Right, exactly, and I do what we're gonna talk about,
so should we get to it?
- Well the other thing, you wanna strengthen the hips also
because you prefer a lot of stress to go through
the hips and not the back
- Right. - When you're lifting,
so you want hips to be strong, too.
- And they all work together. - They all work together.
- The number one rule is any of these exercises we show you,
if they create pain, whether it's in the low back
or down the leg, the sciatica pain,
you want to not do that one. - Yes, absolutely stop.
- So we're going through about
seven or eight exercises here,
so you only may find four or five of 'em
or two or three that you can do without pain.
- And we'll show you adjustments you can try
to see if you can do it without pain.
- Absolutely, so shall we get on with it?
- Yeah, let's start with the first one.
- Number one.
Now this is, this is one I do.
I used to do it more; I'm down to three days a week.
Not this first part, but you may,
you wanna get your back,
you see how I'm moving my back right here?
- [Bob] Yeah, he's making more of an arch or less of an arch
underneath the back.
- And you're gonna put it in a location
that feels no pain or a minimal amount of pain,
then you're gonna tighten up your stomach muscles,
and you can start out with just one knee to the chest,
and with all these, we're gonna shoot for 10 repetitions.
I'm not gonna do 'em here because we wanna get on with it.
So if one knee to the chest is too easy,
then you're gonna go two knees.
Now we're not gonna grab the knee and pull up tight
or do it any of this.
We're just gonna tighten up,
adjust the back so it's pain free,
tighten up the core, and lift till our knees
are up towards the ceiling.
- [Bob] Now some people will actually take their hands
and put it underneath their back, Brad.
- Yep, right here.
- [Bob] Or even underneath their back themself
in order to give it a little more support.
- Yep, whichever way makes the back feel better.
Now, if you have a ball,
a ball does come in handy for some of these exercises
as there's no way around it,
and it can be very helpful.
They're not that expensive.
If you got back pain and it helps, it's worth it.
This is what I do.
It keeps my back in neutral,
works my core very well, and this is
one of my mainstays. - Yeah this is one of
your staples, isn't it Brad? - Yep.
- You've been doing this for a long time.
- Yep, years, and I do 50 of 'em.
Starting out with 10 is a good number.
Okay, let's go to the next one.
- [Bob] Now you need pretty good hip flexibility
for that alone.
I mean, you need to be able to
abduct your hips pretty good I mean.
- A little key if you do this.
It's a lot easier if you don't have pants on,
but shoes help because the rubber part of the shoe
grabs into the ball right there,
and there's some little tricks that you do have to learn.
Don't get too big if a ball 'cause then
it's hard to grab a hold of. - Exactly.
- All right, so the next one,
and this is a straightforward one.
I put my hands across like this, knees up,
and I just bring my head and my shoulder blades
off the floor. - Yep, straight up.
- So I'm not doing this.
We wanna go up like this, then down,
and that'll help keep that--
Again, adjust the back so it feels good.
Tighten the core, that goes with all of these,
and work it like that.
- With this one too Brad,
if it hurts, you may try to adjust your back a little bit.
You could also put your hands
underneath your back on this one, too.
A little harder, and just bring your head up,
straight up again.
Yep, just like that,
and that's maybe more for a beginner.
- Right, or if depending on the degree
your back is irritated at the time.
Okay, good, what do we got next, Bob?
- Next we got opposite knee and elbow.
- Right, and this is one of my cores.
I'll go like this, knees up, and again,
make the adjustments with your back, tighten your core.
Bring your right elbow to your left knee,
and you don't have to touch, but if you go that direction,
all's we're doing is getting some of the oblique muscles.
- [Bob] But look again how he's keeping his back
really pretty straight. - As straight as I can.
I'm thinking about it.
- [Bob] We don't wanna have the curled back,
the curled low back on this.
- I'm not going way up like this.
- [Bob] And again, you have a problem,
and this feels okay for you.
- I use the ball, and this is how I do it.
I go like this, pick up the ball.
Don't expect to do this right away
'cause holding the ball and doing these
takes a little bit,
but you just start out with baby exercises,
and this one really, it just feels good on my back
all the way around.
I don't have any problems with it at all.
- [Bob] Then someone with sciatica,
that could be a problem.
- Yep, exactly, so that's the question mark one.
- [Bob] Yeah, stop immediately if it starts causing pain
down your leg or if you feel pain down your leg
afterwards, right afterwards.
- And then of course, you're not gonna hop up like that.
If you're down here, you gotta think about--
- Rolling to your side. - Yep, rolling to your side.
Keeping a neutral back.
- [Bob] Tightening up your stomach maybe
- Yep, furniture next to it,
and it all depends on how bad your back is, of course.
It could be if it's so bad,
you may not be able to do these.
All right, hips.
- Get some hip strengthening.
- Ahh, hip, we'll work the gluteus.
So in this position,
we're gonna find the comfortable position.
Fully arched or up,
usually times it'll be in between there somewhere.
Tighten up your core, and we're gonna do hip extension
at about this speed.
- [Bob] What's nice about this one,
you're actually getting some back strengthening
with this, too. - Oh yeah, yep.
- [Bob] So you're getting kind of a double benefit,
and again, if you are hurting, readjust the spine,
and also tighten up your abdomen and see
if any of those take away the pain.
- Sometimes, you just go to the ball
and do it with a ball,
and that takes a lot of stress off of your back.
- [Bob] This takes a lot of stress off the back, absolutely.
- And it is a little bit cheating,
but you're doing it for a good reason,
to protect your spine,
get exercise while that back heals up.
- [Bob] Now interestingly enough,
your glutes, butt muscles actually kinda become
deactivated with back pain quite often.
- Sure.
- And so we need to reactivate them,
and that's a great one for that.
- Exactly, now the next one's sideline.
If we're talking about hips,
it's nice to keep the hip abductors strong
to stabilize your spine, particularly when walking.
The first one I'm gonna show is hip abduction,
so sideline, and here you may have to make
some little adjustments so that you're comfortable,
so forward and backwards, and if you're not comfortable,
just don't do this one.
And we're just gonna go up and down like this.
- And generally what's gonna make you more uncomfortable
is if you go more back like this
'cause now you're getting a little twist in the back
while you're doing this,
so you wanna be really generally straight up and down.
- Right, and the tendency is to kinda kick forward
and bring your toe up like that.
We don't want that, we wanna keep it straight
in line with your body.
- [Bob] Toe pointing straight forward.
- Yep, even a little bit down may help with it.
You'll feel that hip abductor working well.
There's another way to do this, but while I'm down here,
I'm gonna show you the clamshell.
This is a nice one, it's easier.
It'd be nice to have a pillow, Bob.
Don't worry about it. - I was looking!
- No, don't worry. - There's no pillow here.
- [Bob] I looked before, oh wait, here,
I'll give you the have a nice day
or have a good day pillow. - Oh good, thanks.
So it's simply the clamshell.
It's not real aggressive, but I can tell you--
- [Bob] This is a great one because it's gonna--
- It's harder than it looks.
- [Bob] Yeah, it's gonna work the glutes
and the hip abductors,
and this is a fantastic one to do
- Right. - For back pain.
- Now I did mention there's another option
for the hip abduction, and if you have the ball,
you can try this.
Now if you're not used to the ball,
this is pretty wobbly,
so you have to have something to hold on to,
a chair, a wall in front of you.
I feel comfortable on the ball 'cause I use it a lot,
and then you go like this, and this supports the back.
Again, tighten up the core,
get things in that neutral, pain free position,
and then do your exercise,
and then naturally get off the ball slowly.
Go to the other side.
- Yeah again, great exercises if you can do them
because they're gonna help you in the long run
do things correctly like when you're working
and doing something, you wanna keep your back straight
and you wanna put the stress on the hips.
- Yeah, if you have an injury,
the worst thing you wanna do is just lay down
and let it try to heal without activity.
- Nope, you gotta keep moving.
You gotta get walking, too.
Remember, Brad and I can fix just about anything.
- Except for - A broken heart.
- There you go. - But we're working on it.
There we go.
(techno music)